Individual
SUSAN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
360 N MAIN ST, WASILLA, AK 99654-7017
(907) 357-7962
Mailing address
607 SW HIGGINS AVE, MISSOULA, MT 59803-1468
(406) 541-1700
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM6101
STATE
AK
Enumeration date
08/09/2010
Last updated
08/09/2010
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